Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast Episode 259: Keywords part 23: Pulse-Ox and hemoglobinopathies part 1
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Jul 16, 2023 Dr. Gillian Isaac, expert in ABA key words, discusses pulse oximeters and hemoglobinopathies. The podcast covers the basics of pulse oximetry, its limitations, and the effects of methylene blue and met hemoglobinemia. The speakers also explore the accuracy of pulse oximetry, substances that can affect readings, and the use of methylene blue in surgeries and treatment. They discuss the association between benzocaine and methemoglobinemia, the side effects of vasodilators, and the diagnosis and treatment of a cyanotic and incoherent patient. The hosts also share random recommendations.
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Pulse Oximetry Basics
- Know pulse oximetry basics and limitations including interference like ambient light and hemoglobinopathies.
- Memorize key wavelengths: deoxyhemoglobin absorbs red light (
660 nm), oxyhemoglobin absorbs infrared (940 nm).
Blue Nail Polish Interferes Most
- Blue nail polish causes the greatest inaccuracy in pulse oximetry readings.
- To avoid errors, place the probe on the nail bed or use an ear probe instead of over nail polish.
Methylene Blue Lowers SPO2
- Methylene blue dye lowers pulse oximeter readings by absorbing light at 668 nm, mimicking deoxyhemoglobin.
- Expect a significant transient drop in SPO2 after methylene blue administration.